沙库巴曲缬沙坦治疗临床阶段舒张性心力衰竭的临床分析  

Clinical analysis of Sacubitril⁃Valsartan in patients with clinical diastolic heart failure

作　　者：彭锦 张缤月 戴慧勇 曹佳[1] 毛亮[1] 朱玲玲[1] 姚贤萍 张园园 PENG Jin;ZHANG Binyue;DAI Huiyong;CAO Jia;MAO Liang;ZHU Lingling;YAO Xianping;ZHANG Yuanyuan(Department of Cardiology,the 928th Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army,Haikou 571159,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第928医院心内科,海口571159 [2]海南医学院第一附属医院心内科,海口570102 [3]急救与创伤研究教育部重点实验室,急诊创伤学院,海南医学院,海口571199

出　　处：《实用医学杂志》2021年第11期1461-1465,共5页The Journal of Practical Medicine

基　　金：急救与创伤研究教育部重点实验室(海南医学院)开放课题基金(编号:Grant.KLET⁃202019);海南省自然基金(编号:819QN366);海南省科协青年科技英才项目(编号:QCXM201901)。

摘　　要：目的分析沙库巴曲缬沙坦治疗临床阶段舒张性心力衰竭的有效性及安全性。方法选取2019年6月至2020年6月在第九二八医院及海南医学院第一附属医院心内科就诊的舒张性心力衰竭患者113例,随机分为对照组57例和试验观察组56例。对照组予常规抗心衰治疗,观察组将对照组中ARB/ACEI替换为沙库巴曲缬沙坦。随访前比较两组的临床资料,随访6个月后分析两组的血压、6 min步行试验NT⁃proBNP、AST、ALT、SCr及血钾水平;并比较了两组的心超相关指标及再住院率、MACE发生率、不良反应发生率。结果治疗6个月后,观察组的6MW、NT⁃proBNP、LVEDVI、LVESVI及E/e′结果较对照组明显改善,且对肾脏的保护作用优于对照组;观察组再住院率、不良反应发生率明显低于对照组,而两组间的血压、肝功能、血钾、EF、LAVI水平及MACE发生率差异无统计学意义。结论沙库巴曲缬沙坦治疗临床阶段舒张性心力衰竭安全、有效。Objective To observe and analyze the effectiveness and safety of sacubitril⁃valsartan for dia⁃stolic heart failure.Methods A total of 113 participants confirmed with diastolic heart failure and ejection fraction of 50%or more from the cardiovascular department of the 928th Hospital of the Chinese People′s Liberation Army and the First Affiliated Hospital of Hainan Medical University from June,2019 to June,2020,were selected and randomly assigned to control group(n=57)andexperimental observation group(n=56).The control group received conventional anti⁃heart failure therapy.The treatment plan of the observation group replaced the ARB/ACEI with sacubitril⁃valsartan instead.During the 6 month of observation and regular follow⁃up,we collected the baseline characteristics and clinical information before the research and analyzed the levels of blood pressure,6⁃min walking test(6MW)results,serum N⁃terminal pro⁃brain natriuretic peptide(NT⁃proBNP),AST,ALT,SCr,and potassium levels of the two groups.Meanwhile,cardiac ultrasonography related index of the two groups were tested and analyzed.Additionally,readmission rate,MACE and adverse reactions rate of the two groups were collected and compared.Results The clinical effective rate of the observation group was significantly higher than that of the control group.Greater reductions from baseline were found in patients who received sacubitril⁃valsartan,including 6MW,NT⁃proBNP,LVEDVI,LVESVI,and mitral E/e′ratio.The effectiveness of the drugs and the protection of the kidneys in the experimental group were also better than those in the control group.Readmission rate and adverse reactions rate were decreased in the experimental group.However,there were no statis⁃tically differences in the blood pressure,liver function,serum potassium,EF%,LAVI levels and MACE between the two groups.Conclusions Sacubitril⁃Valsartan was effective and safe in the treatment of.clinical diastolic heart failure.

关 键 词：沙库巴曲缬沙坦 舒张性心力衰竭 NT⁃proBNP 二尖瓣E/e′ 药物疗效性评价 

分 类 号：R541.9[医药卫生—心血管疾病]